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December 21, 2012

Study Shows Medical Errors Are Commonplace In Surgery

by editor

Lawrence LeBlond for redOrbit.com - Your Universe Online

While surgery is something you hope you never have to go through, it is something you expect will go smoothly when you do have it. And while nine times out of ten it does go smoothly, you should keep in mind that surgeons are people, and people are not perfect.

Surgeons, who usually subscribe to the philosophy of “never events,”–certain medical mistakes that should never occur–often do make mistakes in the operating room that may or may not go unnoticed.

Most people in the medical community agree that these mistakes, such as accidentally leaving medical equipment in the body, operating on the wrong body part, or even operating on the wrong patient, should never occur under any circumstances. But new research finds that they are more common than one might actually believe.

The study, published in the journal Surgery, has found that medical mistakes such as these occur quite frequently, on the average of about 500 times per year. The study found that between September 1990 and September 2010, more than 9,700 medical malpractice claims have been settled.

And nearly half of those cases were ones in which surgeons left an object inside the patient by accident (the most common object was a sponge). The other half were cases of surgeons operating on the wrong part of the body or performing the wrong procedure. And perhaps most disturbing, 17 cases were of surgeons operating on the wrong person altogether.

And based on an analysis of data from 2004 to 2010, the study authors found that 6.6 percent of these so-called never events actually ended in death for the patients. Furthermore, 33 percent of these patients were left with a permanent injury and 59 percent suffered a temporary injury.

Patients who received the wrong procedure had the highest odds of death or injury. The study also found that younger patients had a better chance of surviving a never event than did patients over the age of 60.

The study authors noted that these findings were gleaned only from paid malpractice claims. Winta T. Mehtsun, the lead author on the study from Johns Hopkins University School of Medicine, said it is difficult to know just how many cases of never events have actually occurred because they were not able to get data on unpaid claims or never events that not been pursued.

But based on the data, Mehtsun said surgeries have cost the healthcare industry about $1.3 billion in malpractice payments over the study period.

Mehtsun and his colleagues also gathered data about which doctors were most likely to experience never events. Doctors who had already experienced a previous malpractice claim were among these offenders. Also were younger doctors with less experience under their belt, having the highest odds of settling malpractice claims.

The researchers point to past studies that trace medical errors back to a lack of leadership or communications. It has been shown that hospitals that use checklists have a higher success rate of communications between health-care providers. Others have also stepped up on their review processes to keep medical errors from occurring.

“We trail behind other high-risk industries that have used systematic approaches to successfully identify and reduce sentinel errors,” the researchers wrote. “Strategies used in other complex systems such as aviation may help provide a blueprint to examine both the individual and the institutional factors that contribute to these preventable and costly events.”

Dr. Martin Makary, study coauthor, said even though these never events are relatively rare, they should be entirely preventable. He noted that the annual number of reported events has been on the decline, but he said even one preventable error is one too many.

“Surgeons are the captain of the ship, but it´s a team effort,” said Dr. Jeffrey Port, a cardiothoracic surgeon at New York Presbyterian-Weill Cornell who invented a radiofrequency technology to ensure sponges are not left behind in a patient´s body.

The use of safety procedures prior to the start of surgery proved to be a nuisance at first, but over time, as surgeons and operation room staff got used to it, it proved to be an invaluable asset to ensuring patient safety, Port said.

“I don´t think we´ll ever see zero [errors], but we can get very close,” he told Dr. Lauren Browne at ABC News.

“Healthcare is operated by good people, but they´re still human,” said Makary. “The better able we are to remove errors from the system, the safer healthcare can be for everybody.”